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MSK > Nerve Palsies in the Limbs > Flashcards

Nerve Palsies in the Limbs Flashcards

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1
Q

Definition of a dermatome

A

Sensory area of skin supplied by a single spinal nerve

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2
Q

How to remember lower limb dermatomes

A

STAND on SI
SLEEP on S2
SIT on S3
SHIT on S4

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3
Q

What is Hiltons Law?

A

The nerves crossing a joint supply the muscles acting on it and the joint itself

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4
Q

Definition of myotome

A

Group of muscles supplied by one segment of the spinal cord

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5
Q

What is the component of a dorsal route?

A

Sensory

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6
Q

What is the component of a ventral route?

A

Motor

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7
Q

C5 myotome pattern

A

elbow flexors

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8
Q

C6 myotome pattern

A

wrist extensors

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9
Q

C7 myotome pattern

A

elbow extensors

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10
Q

C8 myotome pattern

A

finger extensors

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11
Q

T1 myotome pattern

A

intrinsic hand muscles

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12
Q

L2 myotome pattern

A

hip flexors

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13
Q

L3 myotome pattern

A

Knee extensors

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14
Q

L4 myotome pattern

A

ankle dorsiflexors

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15
Q

L5 myotome pattern

A

long toe extensors

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16
Q

S1 myotome pattern

A

ankle plantar flexors

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17
Q

What is the brachial plexus?

A

Large network of nerves supplying the upper limb, extending from the cervical spine to the axilla

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18
Q

What is the prefixed plexus of the brachial plexus?

A

C4-8

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19
Q

What does the brachial plexus consist of? RUSSEL TAILOR DRINKS COLD BEER

A 
Roots
Trunks
Divisions
Cords
Branches
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20
Q

What do the cords of the brachial plexus lie in relation to?

A

The axillary artery

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21
Q

Roots and cord of the axillary nerve

A

C5, 6

Posterior cord

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22
Q

What does the axillary nerve wrap around?

A

The surgical neck of the humerus

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23
Q

What does the axillary nerve supply?

A

Deltoid and teres minor

Skin over lateral arm = regimental badge area

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24
Q

What results from axillary nerve palsy?

A

Deltoid atrophy
Loss of shoulder abduction (deltoid)
sensory deficit over badge area

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25
When is the axillary nerve at risk?
Fracture of humeral neck Shoulder dislocation Saturday night palsy (pressure on posterior end of the brachial plexus)
26
Roots and cords of the radial nerve
C5,6,7,8, T1 | Posterior cord
27
What does the radial nerve supply?
Triceps BCR ECRL ECRB
28
What two muscles does the radial nerve pass through to get to the forearm?
Brachioradialis | Brachialis
29
When is the radial nerve at risk?
Fracture of the humeral shaft Saturday night palsy Exposure of the proximal radius
30
Presentation of radial nerve palsy
``` Wrist drop (extensors) Sensory deficit in 1st webspace dorsally Loss of elbow and wrist extension Sensory changes in forearm and hand Loss of finger extension (PIN) Loss of sensation at wrist (SRN) ```
31
How could radial nerve entrapment occur?
Humerus fracture
32
Roots and cords of the median nerve
C5,6,7,8, T1 | Medial and lateral cords
33
What does the median nerve supply?
``` Flexor of forearm - bar FCU - medial half of FDP LOAF muscles - L = lateral 2 lumbricals - O = opperves pollicus - A = adbuctor pollicus brevis - F = flexor pollicus brevis Sensation to radial 3.5 digits ```
34
When is the median nerve at risk?
carpal tunnel syndrome wrist lacerations supracondylar fractures
35
Presentation of medial nerve palsy
``` Thenar wasting (monkey hand) Pointing finger Sensory deficit to volar aspect of thumb ```
36
Roots and cords of ulnar nerve
Roots C7,8, T1 | Medial cord
37
What does the ulnar nerve supply?
medial half of FDP and FCU all instrinsic muscles of the hand BAR LOAF Sensation to ulnar 1.5 digits
38
When is the ulnar nerve at risk?
Fracture of humeral condyles | wrist lacerations
39
Presentation of ulnar nerve palsy
``` claw hand - hyperextension at MCPJ, flexion at IPJs hypothenar and 1st dorsal IO webspace sensory deficit of little finger Guttering Ulnar paradox ```
40
Roots and cords of musculotaneous nerve
C5,6,7 | Lateral cord
41
What does the musculotaneous nerve supply?
Elbow joint
42
Causes of carpal tunnel syndrome
``` Developmental Idiopathic Trauma (distal radius fracture) Swelling - ganglion, fibroma, lipoma Inflammatory - RA - gout - TB - amyloid metabolic - pregnancy - mucopolysaccharides - hypothyroidism ```
43
Symptoms of carpal tunnel syndrome
Nocturnal pain and paraesthesia in part or all the median nerve distribution wasting of thenar muscles (once wasted, unlikely to return) numbness on ulnar side of hand and difficulty doing fine tasks
44
Investigations for carpal tunnel syndrome
``` Look for - thenar wasting - previous scars - deformity (previous fracture) Feel = sensation more - APB power Special tests - Tinnels and phannels Froment's test ```
45
Roots of the sciatic nerve
L4, 5, S1, 2, 3
46
What does the sciatic nerve supply?
Posterior thigh muscles Leg muscles Foot muscles
47
What does the inferior gluteal nerve supply?
Gleuteus maximus
48
Roots of the lumbar plexus
L1-5
49
Main branches of lumbar plexus
Femoral nerve LFCN Obturator
50
What is the hip innervated by?
Predominately OBTURATOR NERVE Femoral nerve Lateral femoral cutaneous nerve
51
Roots of the femoral nerve
L2-4
52
What does the femoral nerve supply?
(anterior) quadriceps muscles in thigh | hip joint
53
Roots of the lateral femoral cutaneous nerve
L2,3
54
What does the lateral femoral cutaneous nerve supply?
Purely sensory to the lateral aspect of the thigh
55
What does compression of the lateral femoral cutaneous nerve cause?
Meralgia paraesthesia
56
What is largest nerve in the body?
The Sciatic nerve
57
What does the sciatic nerve supply?
Hamstring muscles (posterior) Part of the adductor magnus All lower leg and foot muscles
58
When is the sciatic nerve at risk?
Posterior dislocation of the hip Intra-muscular infections during surgery
59
Roots of the common fibular nerve
L4-S2
60
Presentation of common fibular nerve deficit
foot drop | slapping gait
61
What does palsy of the common peroneal nerve cause?
Foot drop
62
What is Erbs palsy?
Deficit of the upper brachial plexus (C5,6), traction of C5 + C6 (+/- 7)
63
Presentation of erbs palsy
Waiters tip position - shoulder is adducted and internally rotated - elbow is extended - wrist is flexed
64
What is Klumpe's palsy?
Deficit of the lower brachial plexus (C8, T1), traction of C8/T1
65
Presentation of klumpe's palsy
claw hand | hyperextended wrist
66
What syndrome is the median nerve affected?
Carpal tunnel syndrome
67
What syndrome is the ulnar nerve affected?
cubital tunnel syndrome
68
If someone develops winging of the scapula, what nerve is affected?
Long thoracic nerve
69
When can the long thoracic nerve be damaged?
Masectomy
70
How can nerve root pain be distinguished from other types of pain?
Pain by dermatomal distribution with associated neurological deficit

MSK (25 decks)

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